| NPI | 1104090604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN MARLON RICHEY President 559-784-1922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 33143) |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2008-04-15 |